An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

An American Sickness: How Healthcare Became Big Business and How You Can Take It Back

by Elisabeth Rosenthal


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Product Details

ISBN-13: 9780143110859
Publisher: Penguin Publishing Group
Publication date: 03/13/2018
Edition description: Reprint
Pages: 432
Sales rank: 35,402
Product dimensions: 5.40(w) x 8.20(h) x 1.10(d)

About the Author

Dr. Elisabeth Rosenthal was for twenty-two years a reporter, correspondent, and senior writer at The New York Times before becoming the editor in chief of Kaiser Health News, an independent journalism newsroom focusing on health and health policy. She holds an MD from Harvard Medical School, trained in internal medicine, and has worked as an ER physician. She lives in New York City and Washington, DC.

Table of Contents

Introduction Complaint: Unaffordable Healthcare 1

Part I History of the Present Illness and Review of Systems

1 The Age of Insurance 11

2 The Age of Hospitals 22

3 The Age of Physicians 55

4 The Age of Pharmaceuticals 87

5 The Age of Medical Devices 128

6 The Age of Testing and Ancillary Services 148

7 The Age of Contractors: Billing, Coding, Collections, and New Medical Businesses 166

8 The Age of Research and Good Works for Profit: The Perversion of a Noble Enterprise 182

9 The Age of Conglomerates 205

10 The Age of Healthcare as Pure Business 223

11 The Age of the Affordable Care Act (ACA) 230

Part II Diagnosis and Treatment: Prescriptions for Taking Back our Healthcare

12 The High Price of Patient Complacency 241

13 Doctors' Bills 248

14 Hospital Bills 261

15 Insurance Costs 280

16 Drug and Medical Device Costs 302

17 Bills for Tests and Ancillary Services 319

18 Better Healthcare in a Digital Age 321

Epilogue 328

Afterword 331

Acknowledgments 339

Appendix A Pricing/Shopping Tools 343

Appendix B Tools for Vetting Hospitals 346

Appendix C Glossary for Medical Bills and Explanations of Benefits 348

Appendix D Tools to Help You Figure Out Whether a Test or a Procedure Is Really Necessary 352

Appendix E Templates for Protest Letters 354

Notes 357

Index 401

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An American Sickness: How Healthcare Became Big Business and How You Can Take It Back 5 out of 5 based on 0 ratings. 3 reviews.
Anonymous More than 1 year ago
Rosenthal's book is well-researched and written It is thoughtful and incredibly informative It is a powerful tool for those tangling with our healthcare system or for thosee who simply know it can be better
fem80 More than 1 year ago
Excellent book with practical guides on handling your own confusing bills and great links to health care related resources. And beyond that, it's eye opening how we're all affected by this broken system from dealing with high insurance premiums to doctors being incentivized to be inefficient in order to bill more as opposed to being effective both for our health and our medical spending, and how lives are affected by bad medical devices that don't go through the right FDA approval process, etc. I've actually recently seen some billing issues she described, and was inspired to request the itemized bill as well as to use the reference she provides to compare the bill to relevant fair prices.
ShawnSorensen43 More than 1 year ago
An insider’s view on elaborate fee outlays, insurance perversions and how our medical system has turned its primary focus from patient care to making the most money possible. It is illuminating, alarming, nonpartisan and pragmatic for patients. The World Health Organization says the U.S. is 40th in the world in overall quality of care… yet Americans are forced to spend more on heath care per capita than any other nation on earth… by far. What is driving up costs? Rosenthal gives a few examples: in 1986 a statue was passed that said all patients who arrived at a hospital's ER had to be treated. But since highly-paid specialists are not required to treat the patients, the hospitals are in a quandary. Therefore, the specialists get to bill whatever they choose. Most European countries regulate drug and medical procedure pricing, but not the U.S. And, incredibly, the U.S. is one of only 2 countries that allow prescription drug advertising!! Medical coding and coders like in the U.S. "essentially don't exist in any other health care system." Having highly skilled codes means another middle man and higher health care bills. Another doozy from the health care book: in 2015, the medical industry spent almost a half a billion dollars on lobbying. The oil and gas industry spent $130 million, investment firms $100 million, defense/aerospace $75 million. By 2014, 52% of overdue debt on credit cards was due to medical bills. National studies have estimated that one-third of all medical procedures are unnecessary. Etc. Rosenthal introduces a 10 Commandments-type list that summarizes the new health care landscape – like “Always recommend the most expensive option to the patient” and “A lifetime of charges is better than a cure.” But there are 18 chapters with a lot of statistics. It might have been better to dedicate a chapter to each of the 10 rules to assist the reader in remembering more of the book. Half of An American Sickness is about solutions. The easiest and most far reaching is for patients to demand price transparency. Your doctor or office should know the price for everything, should be well aware of cheaper options, up front. Most doctors are honest and sharp. Patients only have to deal with the bureaucracy and high prices when we get sick - doctors deal with the difficulties all the time. Rosenthal gives you great tools at the end, like, which calculates a fair price on a large number of procedures that you can use to bargain prices downward. Politically, she recommends some obvious, free-market solutions – the government should be able to bargain for bulk drug prices for pharmaceutical drugs for Medicare and Medicaid, and we should be able to travel to and import drugs from other countries if they are of the same quality. This would also drive down prices and give more care options to Americans. A quick, powerful read with ideas anyone could use right away and for the longer haul towards vitally needed changes.